DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Self, Marissa Kay	DOIID	1005793	NAIC NPN	17108119

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	8/21/2018		9/30/2025
Active	Non Resident	Agent	Property	8/21/2018		9/30/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Nationwide Mutual Insurance Company	301749	Agent - Casualty	9/6/2018
Active	Nationwide Mutual Insurance Company	301749	Agent - Property	9/6/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Nationwide Sales Solutions Inc	631821	Agent - Property	10/30/2018
Active	Nationwide Sales Solutions Inc	631821	Agent - Casualty	10/30/2018